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Individual

DEVON DANIELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
486 W MAIN ST, DOTHAN, AL 36301-1616
(334) 439-0262
Mailing address
1558 MONTGOMERY HWY STE 7, DOTHAN, AL 36303-3300
(334) 439-0262

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1
X
Enumeration date
11/20/2018
Last updated
06/11/2019
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